Biological predictors of third-line treatment outcomes in patients with advanced non-small cell lung cancer.

Abstract

e21597 Background: The introduction of molecularly-guided targeted therapies and immunotherapy in routine oncology practice has led to significant survival increases in a subset of patients with advanced-stage non-small cell lung cancer (NSCLC). Nevertheless, the ultimate prognosis of these patients remains grim, and their overall therapeutic management challenging, particularly beyond the first-line treatment setting. We herein aimed to assess outcomes of third-line treatment in real-world patients with NSCLC, and to investigate potential correlations of clinicopathological and laboratory fearures with survival data. Methods: The medical records of 111 patients with advanced NSCLC, diagnosed and treated at the Oncology Unit of Sotiria Athens General Hospital between January 1, 2015 and December 31, 2018, were retrospectively reviewed. Eligible patients were those who had received more than two cycles of third-line treatment. Clinicopathological and laboratory features of patients, including baseline levels of complete blood count parameters evaluated immediately before administration of third-line therapy, were recorded and correlated with progression-free and overall survival. Results: The majority of patients had lung adenocarcinoma (54.1%) and stage IV disease (64,9%). Progression-free survival rates at 3 and 6 months were 59% and 20, respectively. Risk of disease progression was 35% lower in adenocarcinoma, as compared to other histological subtypes. Increased haematocrit and reduced white blood cell count levels were independently correlated with decreased risk of disease progression [HR (95% CI): 0,95(0,91-1,00); p = 0,044 and HR (95% CI):.1,05(1,00-1,11); p = 0,048, respectively]. Furthermore, higher white blood cell count and platelet count levels were independent predictors of decreased survival [HR (95% CI): 1,05 (1,01-1,1); p = 0,018 and HR (95% CI): 1,02(1-1,04); p = 0,018, respectively]. Conclusions: Haematocrit, white blood cell count and platelet count, recorded immediately before initiation of third-line therapy, may represent independent predictors of survival parameters in patients with advanced NSCLC.